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Position papers from The Third National Injury Control Conference: Setting the national agenda for injury control in the 1990s, April 22-25, 1991, Denver, Colorado. Atlanta, GA: National Center for Environmental Health and Injury Control, 1992 Apr; :65-71

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NIOSHTIC No.

20033094

Abstract

Improvements in emergency medical systems, trauma centers, injury prevention, and medical and surgical management have resulted in increased survival rates for people with serious injuries. Mere survival, however, is not enough; children and adults with injuries need rehabilitation and educational services to help them regain biologic, psychologic, and social functions. These services must be comprehensive, longitudinal, and coordinated. Rehabilitation must be seen as part of a continuum of care provided to people with injuries by an interdisciplinary team and by the injured person's family from the early acute stage to the end of the person's life, if necessary. In terms of human suffering and costs, injuries exact a huge toll, especially injuries in the following six major categories for which a person requires intensive rehabilitation services. 1. Spinal Cord Injury. Estimates of people with spinal cord injury (SCI) in the United States range from 177,000 to 200,000, and 10,000 to 20,000 more people receive an SCI each year. Most people with SCIs are permanently impaired, and most have major disabilities. In the United States, the cost of SCI is estimated at $6.2 billion annually. 2. Traumatic Brain Injury. No surveillance data with exact numbers of traumatic brain injuries exist. An estimated 70,000 people annually incur moderate-to-severe head injuries and require long-term rehabilitation services to help cope with cognitive, behavioral, and emotional deficits. Children and young adults are disproportionately affected by traumatic brain injuries and often require lifelong rehabilitation services. 3. Burns. About half of all people who receive burn injuries require medical care. Each year, between 70,000 and 100,000 hospital admissions are for burns; about a third of these admissions are to facilities with specialized burn units. Data are limited on long-term sequelae to burn injuries, rehabilitation outcomes, and the costs of rehabilitation care for burns. 4. Limb Injuries. About half of all hospital trauma admissions are due to injuries to the upper and lower limbs, resulting in a total of $5.4 billion in hospital charges. 5. Back Injuries. Of the estimated 5.2 million Americans with low back pain, about half are chronically disabled. Low back pain is the most common cause of work disability in adults younger than 45 years of age. The cost of compensable low back pain has been estimated at $11 billion. 6. Poly trauma and Other Injuries. Poly trauma (injuries to more than one body system) occurs frequently. For example, about half of all people injured in motor vehicle crashes have multiple injuries, including head, spinal, facial, or extremity injuries. Each year, an estimated 2.4 million Americans suffer from an eye injury, and nearly 1 million Americans now have permanent visual loss as a result of ocular trauma.